What You Need to Know Before Going to the Social Security Appeals Council

Social Security Appeals Council: The Third Level of an Appeal

If you have appealed your disability benefits claim at an administrative law judge hearing, there is about a 33 percent chance that your appeal will be denied by the judge. At this point, you may request a hearing review by the Social Security Administration’s Appeals Council.

It is very difficult to get your benefits granted by the Appeals Council, but having your case reviewed by the council (or dismissed by the council) is a necessary step if you would like to move on to the fourth level of appeal—filing a civil suit in federal district court.

The Appeals Council Picks and Chooses Cases to Review

The Appeals Council does not review all claims. In fact, it will dismiss claims for a wide range of reasons. For example, your claim may be dismissed if you file late, if you do not provide enough evidence, if the claimant dies, or if the Council believes the administrative law judge made the correct decision. The Council is much more likely to review your hearing decision if your ALJ hearing was not executed properly, if there is substantial evidence supporting your case, or if your case brings a larger issue regarding Social Security disability benefits to light. All in all, only a small percentage of claimants will have their denial reversed at this level of appeal.

Three Things to Know About the Appeals Council

Before you pursue this level of appeal, it is important to know more about what may happen if you file an appeal. Specifically, you should know that:

1. The Appeals Council will only overturn the decision of an administrative law judge if the administrative law judge made a procedural error or the administrative law judge’s findings were not supported by the evidence available at the hearing.
2. If the Appeals Council disagrees with the administrative law judge’s decision, it can either send the case back to the administrative law judge level for reconsideration or it can decide the case itself.
3. New medical evidence may or may not be considered. The Appeals Council should provide you with an explanation if it does not consider new medical evidence.

The appeals process may take several months or more.

How to Appeal to the Appeals Council

If you want to file an appeal, you should:

• Act within 60 days. The Social Security Administration (SSA) gives you two months (plus the five days they assume it takes you to receive your notice) to ask for an appeal. If you don’t ask for an appeal during this timeframe, the Appeals Council will likely dismiss your case without hearing it.
• Request a hearing review in writing. Fill out a request review form (which you can either find online or request over the phone) and mail it to the Appeals Council, which is located in Falls Church, Virginia.
• Request hearing records if needed. In appealing your case, you may wish to review your administrative law judge hearing and the evidence that was heard.
• Be sure to include any extra information or evidence with your hearing review request. The Appeals Council tends to choose cases for review that have compelling evidence or in which an administrative law judge hearing was not conducted correctly. Be sure this information is included with your request.

Although few cases are won by claimants at the Appeals Council, requesting a hearing review by the council is a necessary step in the appeals process.

You May Benefit From Legal Representation

If you have been appealing your denied Social Security disability claim without legal help up to this point, this may be an excellent time to speak with a knowledgeable, experienced disability lawyer.  At Morgan & Weisbrod, we can help you understand why your claim was denied and whether continuing up the ladder of appeals is the right decision for you and your family. Call us at 800-800-6353 or fill out the electronic contact form on this page to schedule a free consultation with us today.

by Paul B. Burkhalter
Managing Partner of Morgan & Weisbrod, Board Certified in Social Security Disability Law.

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